‘I thought my heart attack was really bad indigestion’

Strabane’s Mary Evans always considered herself a fit and healthy woman. At 65, she regularly walked, cycled, and generally, led an active lifestyle. Therefore, heart disease was the last thing on her mind when she began to feel “under par” earlier this year.

For two weeks in April, Mary had been feeling unusually ‘sluggish,’ but she brushed it off. Having recently recovered from a broken ankle, she assumed her symptoms – chest discomfort, fatigue, and general malaise – were due to reduced mobility and fitness.

“It didn’t occur to me to call the GP because I really didn’t think it was anything serious,” explained Mary. “For two weeks I felt sluggish and under the weather, but I didn’t know what I would tell the doctor. I didn’t know how to describe my symptoms. I put the chest discomfort down to indigestion, feeling lazy or feeling unfit.”

It wasn’t until a chance conversation at her local pharmacy that Mary’s life took an unexpected turn.

On Wednesday, April 17, Mary went to her local pharmacy for over-the-counter medication to treat what she thought was indigestion. When she went to the till to pay, she remarked to the cashier, “I am either having the worst indigestion of my life or I am having a heart attack.” Despite saying this, Mary didn’t seriously think that she was having a heart attack. However, the cashier was concerned and strongly suggested that Mary speak to the pharmacist who asked her to describe her symptoms.

When the pharmacist asked Mary, “are you breathless on exertion?” she was then advised to contact the GP. The GP told Mary that the symptoms she was experiencing could be angina, so she was referred to the emergency department.

Mary continued, “Thinking of the symptoms of a heart attack I would have thought of crippling chest pain or shooting pains in the left arm, but I just felt like I had really bad indigestion.

“I was sent to the Cardiac Assessment Unit where the medical team attended to me immediately. I really felt I was wasting their time and kept apologising for being there for what I thought was indigestion.”

The medical team did a troponin test which showed that Mary’s troponin levels were high. The same test was repeated after four hours and by then Mary’s troponin levels had increased further. The doctor told Mary that they would do an echocardiogram and a coronary angiogram.

“I didn’t really take in what the doctor was saying to me as he did the angiogram, probably because I didn’t want to take it in. The nurse subsequently told me that I had experienced a heart attack, and that one artery was 70 per-cent blocked. I only heard the words ‘heart attack.’”

Mary even remarked that she feels immense responsibility for having a heart attack.

“I never thought a healthy woman like me could have a heart attack,” she admitted. “I was active, I walk and cycle a lot.

“I didn’t want to call the GP because I know how busy they are, and I didn’t want to waste their time”. Mary’s story reflects a troubling reality: Coronary heart disease (CHD) is one of the leading causes of death for women in the North, killing twice as many women annually as breast cancer. Yet misconceptions about heart attack symptoms persist, often leading to delayed diagnoses and treatment.

A recent report by the British Heart Foundation Northern Ireland (BHF NI) highlights these disparities.

It found that women are 50 per-cent more likely than men to be misdiagnosed or face delays in treatment following a heart attack. Additionally, a survey by BHF NI revealed that only 14 per-cent of women feel ‘very confident’ in recognising heart attack symptoms.

Mary’s experience mirrors these findings. Instead of the dramatic chest pain or shooting pain down the left arm often depicted in media, her symptoms were subtler: Chest discomfort, fatigue, and breathlessness.

A Call to Action

On Wednesday past, Mary travelled to help BHF NI launch their heart attack gender gap report.

Ultimately, the BHF NI is calling for urgent action to close the heart attack gender gap. The organisation has urged the Northern Ireland Executive to develop a Women’s Health Action Plan that prioritizes cardiovascular health and addresses inequalities in diagnosis and treatment.

“Women like Mary are disadvantaged at every stage of their cardiac journey,” stated Karen McCammon, Health and Care lead for BHF NI. “From awareness to diagnosis to treatment, the system fails women, leading to higher mortality rates.”

Mary’s delay in seeking help is a common story. Many women downplay their symptoms, unaware of the risks.

“I never thought it could happen to me,” Mary reflected. “I didn’t recognise my symptoms as a heart attack. I thought I was being silly.”

For Mary, the turning point came when she met a pharmacist who took her symptoms seriously. This small intervention may have saved her life. But not all women are so fortunate.

She now hopes her story will inspire other women to listen to their bodies and seek help when something feels off.

“Don’t ignore it,” she advised. “You’re not wasting anyone’s time. Your health is worth it.”

She concluded, “I want other women to know that it can happen to anyone,” she said. “The sooner you act, the better your chances.”